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Dr. Gallant is talking about a preventative vaccine. A goal not to far is a cure. A preventative vaccine is a difficult task due to the viral rampup in the first 7 days of infection when the virus does the most damage to your immune system and settles in the reservoirs. Like everything else, the rate of progress is directly related to the funding.... How badly do you want it? This observation is the thrust of the AIDS policy project. Although I admire Dr.Gallant, his, is only one opinion . The path is there, now the real desire is necessary ..... this disease must be cured!!

And if the whole world works together, with the help of Bill Clinton and Sean Penn, we can rebuild Haiti.

mecch,

I'm glad you brought Haiti into the discussion. Did you know:

1) 40% of Haitians do NOT have access to primary health care, let alone HIV meds.2) UN estimates 6% of the population are infected with hiv/aids (the highest rate in the western hemisphere.3) 150,000 aids ophans

This is just one small country. AIDS affects every country on the planet with the accompanying health burden.Is the above stated not reason enough to put the collected minds of the world and fund a "Manhattan Project" to cure this disease?

A cure would do more for Haiti and other countries than any other aid. It would free-up funds to rebuid the country and provide for a better future. Think of the problems that would go away with a cure and not just in Haiti.

Below are highlights from the report from The AIDS Policy Project, the subject of the aidsmeds.com article:

1) Who knows exactly what’s going on with AIDS cure research? Not many people outside the research community. Not members of the general public, nor most health reporters. Nor the United States Congress, which decides how much to fund the National Institutes of Health. Not even most AIDS activists, who assume that the cure is decades out of reach. And most importantly, not people with AIDS themselves, millions of whose lives are at stake.

2) The second thing to know is that AIDS cure research is astonishingly underfunded. Many of us assumed that it was awash in money but that the scientific problems were just too complicated to solve. In fact, we have learned something quite different.

3) There are only 12 clinical trials at the Division of AIDS focused on a cure since 2005. Of those, only 3 are enrolling (1 since 2006, 1 since 2007 and for 1 there is no information), 3 are in development, and 3 are “pending.” This means that there is little translation of basic science into producing AIDS cures that could be used by people.

4) Vaccine trials take years and thousands of patients. AIDS cure trials may require only a few dozen patients. The US government spends $1.6 billion2 every year to pay drug companies for AIDS meds via the AIDS Drug Assistance Program, which makes AIDS drugs available to many Americans living with HIV.

5) Even now, researchers are loathe to publicly admit that they are actually searching for a cure for AIDS: In the scientific community, it is considered naïve. Even if now the science is actually, almost secretly, going well. (There is no such stigma in saying that you are working toward a vaccine against AIDS. Nor should there be.)

I agree the US can't do it alone (although CHAVI et al. is as close as it comes). A preventative vaccine would take too long as the policy suggests, thus, follow the pathway to a cure. The science is progressing. Direct the funds toward a cure and let the world chip in. I know" easier said then done"(egos etc.), however, if the science is there, it would benefit all.

Inch,Your link seems to time out. When I tried to post the link, it did the same for me.

If you want a Manhattan Project for an AIDS vaccine you're going to have better luck doing it in Beijing, not DC... or even the EU for that matter. At least in the current economic climate.

That is so true about Beijing. The Chinese don't look at HIV through the political / moral prism nearly so much as it's done here in the US. There it's seen more as an increasing drain on resources and productivity and therefore an obstacle to the insatiable collective quest for economic growth and prosperity, Kind of an ROI issue vs. a humanitarian one. That plus the relative lack of regulation and bureaucratic red tape to get a potential cure to trial is what keeps that part of the world on my radar screen.

Its pretty interesting. I think thats why i've become a more a realist than optimist when i hear about "cure" research. But here's to hoping =)

Wow, sobering article. My hope in regards to HIV though is that if and when some research group does come up with a cure, functional or otherwise, the publicity, hype and attention storm it garners overwhelms the regulatory morass, pharma greed and apathy, and, to an extent, lack of political will. If you believe in following the money, there's a massive amount of it to be made by some company as well as saved by governments around the world who are currently spending billions on treatment. Only a conspiracy theorist would imagine that a cure or revolutionary therapy would languish in some big pharma dungeon not ever seeing the light of day without the word getting out. Could it happen? Sure, no doubt. Is it likely? Hard to imagine.

According to the report, above, Gilead is working on cure studies, which I found surprising but heartening.

To this day, much of the AIDS cure research takes place in universities and at the NIH, instead of at drug companies—though some drug companies, like Gilead, are in fact initiating important AIDS cure studies.

amfAR's Cure Consortium is a step in the right direction in establishing communication between scientists:

A Call For Collaboration

Specialization has its place, but truly innovative advances in HIV research usually come from interdisciplinary efforts, reports Unmesh Kher.

From the article:

amfAR has awarded the bulk of its funding to three collaborative teams that will each address distinct aspects of the problem. These groups are expected to talk frequently and, where helpful, participate in each other's projects. NIAID's programme would also seek to support a collaborative effort that includes teams from academia, the private sector and the US National Institutes of Health — much as was envisioned in the Science paper.

Let's not forget the Ragon Institute, whose mandate is to cure HIV/AIDS:

Excessive specialization has also hampered the flow of information between researchers. For example, HIV immunologists rarely interact with immunologists in other fields, notes Bruce Walker, professor of medicine at Harvard Medical School, and director of the US$100 million Ragon Institute, launched last year in Massachusetts with an explicitly interdisciplinary mission.

My cynical comment about Haiti was meant rather to express the glimmer of hope that someone with enough character and charisma can rally for such necessarily international initiatives. I had just watched an Anderson Cooper report that showed warehouses of food, undistributed, starving orphans, gross tent cities, idle reconstruction equipment, the list goes on and on. And Bill Clinton said it IS possible to get everyone working together but.... But what....

You see the human will is there, the generosity is there. (Although billions pledged to Haiti have yet to be distributed, Bill Clinton said he called the donors and not a one said it would rescind the donation).

Something magical, some special ingredient, is missing. Maybe its confidence, will, ego, and necessity - combined. What made a Manhattan project possible?? Maybe for the world, turning around Haiti isn't necessary, nor curing HIV disease.

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“From each, according to his ability; to each, according to his need” 1875 K Marx

It's good news to see that Gilead isn't abadoning HIV research after its quad pill is approved. But their timing seems too convenient. A year or so before Sustiva goes off patent, voila... the quad pill arrives. Because its side-effects are less than Sustiva, there's a possibility Gilead will be able to continue its franchise for another ten years... then hopefully the cure. My guess is they want a functional cure... not a vaccine. That way, they will maintain their franchise for yet another ten years. When one gets HIV, a very expensive treatment regimen will be applied to rid the patient of the virus.... only to get reinfected and do it all over again. That would be the ultimate pill where they could charge something like what is now a full year's cost of ARVs... now think about how many times a year one could be reinfected... twice, three times, ? ... and how much more they could make than the 2Billion they pull in from HIV drugs today.

It's good news to see that Gilead isn't abadoning HIV research after its quad pill is approved. But their timing seems too convenient. A year or so before Sustiva goes off patent, voila... the quad pill arrives. Because its side-effects are less than Sustiva, there's a possibility Gilead will be able to continue its franchise for another ten years... then hopefully the cure. My guess is they want a functional cure... not a vaccine. That way, they will maintain their franchise for yet another ten years. When one gets HIV, a very expensive treatment regimen will be applied to rid the patient of the virus.... only to get reinfected and do it all over again. That would be the ultimate pill where they could charge something like what is now a full year's cost of ARVs... now think about how many times a year one could be reinfected... twice, three times, ? ... and how much more they could make than the 2Billion they pull in from HIV drugs today.

Gilead is not hiding the fact that Gilead is MEANT to replace Atripla when the patent expires. I've read their financial presentation about future drug pipeline - and they explicitly say that. So it's not really a conspiracy theory.

It's confusing though because Atripla is made up of three separate drugs that probably have three separate expiration dates. I guess by 2014 all three have expired?

The link from drugpatentwatch.com has 3 different Atripla expiration dates: 2010, 2013 and 2014.

Despite the fact that Atripla is made up of component drugs, the combination one pill therapy is considered a different "drug" and as I recall it goes off patent in 2018. Although that gives it a 12 year patent life which seems long. I thought drugs had a 10 year patent life?

Fair game however about the conspiracy theory cynicism about what pharma wants - expensive functional cure. Though I personally don't believe in that conspiracy theory.

To make it short, pharma is in some way delaying a cure. Obviously they don't hide it in a vault but they aren't scream for it either. Their investments in a cure a very tempered as those from the government and the other nations. It's al quite sad because they don't recognize the really need for a cure. It is not a priority for them.

Gilead expects a happy time considering that Merck stopped right now their CCR5 antagonist and other companies stopped their HIV program. They should have a blockbuster in their hands with the Quad pill.

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sign the petition launched by the aids policy project addressed to the nih aimed to increase the money needed to find the cure:

To make it short, pharma is in some way delaying a cure. Obviously they don't hide it in a vault but they aren't scream for it either. Their investments in a cure a very tempered as those from the government and the other nations. It's al quite sad because they don't recognize the really need for a cure. It is not a priority for them.

Gilead expects a happy time considering that Merck stopped right now their CCR5 antagonist and other companies stopped their HIV program. They should have a blockbuster in their hands with the Quad pill.

Let's work some logic shall we?

Drug companies make money off of drugs. A cure eliminates the need for drugs. A cure makes the drug companies no money.

Why on Earth would they want a cure for anything? The business' reason for existing is to make money, anything that hinders that goal is not something they would be interested in. So while I doubt they have a cure, they have absolutely no financial interest in seeing a cure developed. I'm not sure why they doesn't make "horse sense" to everyone.

Universities and national research institutes do a lot of research and they have no interest in prolonging the usefulness of HAART, though they do have interest in making HAART better. Rather there would be untold glory to the teams that come up with a cure.

I agree that pharma has an interest in keeping ever better drugs under patent but that does not equal the cynical plot to never work on a cure. Also, you have all given the hypothesis that the cure would be expensive, so pharma, if it developed it, could make money, although nations would break that patent pretty quickly in the name of human rights. If universities or national institutes developed the cure, they'd probably need pharma in the development and production of said cure, and its implementation.

I agree pharma does what it does to make a profit. But that doesn't equal cynical conspiracies to thwart the advancement of medicine and science.

Research in universities, institutes and pharma is done by scientists and most have ethics and morals.

Drug companies make money off of drugs. A cure eliminates the need for drugs. A cure makes the drug companies no money.

Why on Earth would they want a cure for anything? The business' reason for existing is to make money, anything that hinders that goal is not something they would be interested in. So while I doubt they have a cure, they have absolutely no financial interest in seeing a cure developed. I'm not sure why they doesn't make "horse sense" to everyone.

Well, money is important but they must find cure.Why they scientist report last year that the have sequenced whole HIV-1 genome?Well we all know that medicine ant technology goes every day better and better, so finding cure depends of course science, technology, and naturally money!It seems lot of people like ARVs and they all fine with meaning that HIV is manageable chronic disease!Well it is not it is fuckin virus, nothing else so logic is to find cure!(egg. curing hepatitis c is now better in % with telepavir in clinical trials)ARVs will if we use them in long period(10, 20, 30 or more yrs) of time destroy body and organs not HIV,so we must all demand cure!If people was not unite in 80s they then we will not have AZT.When will be people unite and demand governments, doctors, scientists and pharma then we will se cure!Of course if is money problem(eg pharma wont invest money in cure or governments dint give enough to find cure..) then we must seek money and donate money (or course who can) to research and then hoping to find something!If HIV can spread like plaque i think, no i know we will have cure very soon!Swallowing tablets all life is not solution!

A "cure" can actually mean more $$$ for the company that owns it. Why? Think in terms of Syphillus. It was once also a deadly STD, like HIV. Now there is a "cure." However, you can be reinfected. Reinfection requires retreatment. If a functional cure for HIV does come to be, there's no reason that it won't one day be seen in the same way Syphillus is now.

In the days before AIDS, STD clinics in San Francisco were often revolving doors for some, as they sometimes picked up an STD every few months. A friend in San Fran used to recount tales of his own experience and those of his cohorts. Unless you've visited the baths in San Fran before AIDS, I don't expect you to comprehend the gay culture then.

As far as being evil... LOL I'm definitely not a moralist. Getting reinfected with an STD just comes with the territory of free love and the bath house culture prior to AIDS. Even though its been an entire generation in hiatus, I still believe the party will start all over again once HIV is tamed. There's just too much $$$ to be made and men are men, be they gay or straight.

Drug companies make money off of drugs. A cure eliminates the need for drugs. A cure makes the drug companies no money.

Why on Earth would they want a cure for anything? The business' reason for existing is to make money, anything that hinders that goal is not something they would be interested in. So while I doubt they have a cure, they have absolutely no financial interest in seeing a cure developed. I'm not sure why they doesn't make "horse sense" to everyone.

It makes sense to me. If a drug company came up with a cure, they would have to charge thousands for it to make money they would be losing. If they did that, they would be vilified for keeping a cure from people--much more than now. So, they'd have to give it out for free or a really low charge. The only reason I could see they would want a cure would be to say they cured HIV/AIDS.

I remember watching a program about 6 years ago about drug companies. They were saying for the most part, drug companies don't come up with drugs to cure cancer or HIV. The program talked about all the heart burn pills, toe fungus, and cock pills. Obviously HAART was huge, but wasn't most of that research done outside major drug companies?

Universities and national research institutes do a lot of research and they have no interest in prolonging the usefulness of HAART, though they do have interest in making HAART better. Rather there would be untold glory to the teams that come up with a cure.

I agree that pharma has an interest in keeping ever better drugs under patent but that does not equal the cynical plot to never work on a cure. Also, you have all given the hypothesis that the cure would be expensive, so pharma, if it developed it, could make money, although nations would break that patent pretty quickly in the name of human rights. If universities or national institutes developed the cure, they'd probably need pharma in the development and production of said cure, and its implementation.

I agree pharma does what it does to make a profit. But that doesn't equal cynical conspiracies to thwart the advancement of medicine and science.

Research in universities, institutes and pharma is done by scientists and most have ethics and morals.

d) Corporations compete -- pharma does not act as one when it comes to sales. One comapny with a cure would gladly canniballize the profits of its competitors who sell HAART.

Do not be very sure about that. Like the tobacco companies, when it comes to something that threatens their profits or something, they quickly gather. Also, I work in bussiness fields and corporations for a long time and know some stuff. Economic and other. So you could just make some checks here and there in financial websites and see that most of the biggest corporations have the same shareholders.So basically you are both right and wrong that they are competitors.

A "cure" can actually mean more $$$ for the company that owns it. Why? Think in terms of Syphillus. It was once also a deadly STD, like HIV. Now there is a "cure." However, you can be reinfected. Reinfection requires retreatment. If a functional cure for HIV does come to be, there's no reason that it won't one day be seen in the same way Syphillus is now.

I don't think the situation is the same. HIV reinfection - this would be very very hard to happen. Syphillus is much more likely to be transmitted and the chance is much bigger to be infected. HIV infection chance by itself is very rare (from 1/100 to 1/100000 depending on the persons sex and sex pose).Also, syphullis was a deadly disease, right, but there were many cases of cured people even when there was not a "cure". So sometimes you can cure yourself by its own. That cannot happen to HIV. So they are very different cases - HIV and syph.

b) Scientists are by and large ethical and strive for the betterment of the human condition, which a cure for HIV certainly would be

I agree. Doctors like the berlin doctor Gero Hutter, scientists. My hopes is also on them... Future will tell..But you should agree too, that unfortunatelly in this world ethics are becoming less and less important or part of peopleCheers

The recognition that ART completely suppresses HIV replication in the majority of individuals has revived interest in strategies aiming to deplete remaining latent viral reservoirs, and several large pharmaceutical companies (including Merck and GILEAD) have acknowledged they now have programs working on latency-reversing strategies.

I hate dealing in conjecture but here goes:

It would be hugely profitable for Big Pharma to find a way to deplete latent reservoirs thereby curing HIV. People will continue to become infected, probably in even in larger numbers if there's a cure and they will all be in need of whatever treatment is available for clearing reservoirs. The HIV market would likely expand not contract since it would take a very long time for transmissions to reach such low levels that HIV could be eradicated (decades at least).

But the bottom line is these are all guesses. The point is research continues to move forward and at some point more breakthroughs are inevitable. Existing ARVs were a huge breakthrough and there are bound to be more.